Inconsistent Sleep Patterns and Confusing Sleep Studies - Please Review

[mperry99]

This was an impressive result!

Last night I set the machine to 10cmH2 in CPAP mode with EPR off.  I was also wearing a soft cervical collar to prevent chin tucking.

I had the best sleep in forever!   8 hours and 43 minutes of uninterrupted sleep with an AHI of 3.9.

Where do I go from here with respect to settings?

   

[gainerfull]

Congratulations on the great results - we found a better pressure for you! Considering this is the best sleep you've had in a long time I'm hesitant to recommend additional changes although there are some opportunities to explore if you choose to do so.

[mperry99]

Thank you.

I'm interested in those opportunities.  Please let me know what you are thinking.

[mperry99]

   

Last night was a little different.

I slept with the same CPAP settings (10cmH2o) and the soft cervical collar on.

Although I did sleep through the night (unusual for me), my AHI more than doubled from the the night before, mostly from Clear Airway (CA) and Hypopnea (H) events.

Do you see anything in the OSCAR data that indicates what I can do to get a consistently low AHI score?

[gainerfull]

On your bad nights you're getting into a sleeping position that is closing off your airway and it cannot be solved by pressure. Have you ever considered recording yourself sleeping to see what's up? Does your soft cervical collar prevent your chin from tucking or is there a larger size you can try?

With regard to more recommendations I think that you'd be getting pretty high quality sleep with CPAP mode, 13cmH20 pressure and EPR 3. I am however hesitant to suggest you make a change considering more pressure could lead to more central apneas. A conservative approach would be as follows:

10/14: 11cmH20 + EPR 1
10/15: 12cmH20 + EPR 2
10/16: 13cmH20 + EPR 3

Since we've controlled your obstructive events with CPAP mode @ 10cmH20 this stair step approach will help clean up your sleep disordered breathing even further.

[mperry99]

I haven't tried recording myself, but I'll consider it.  Would I do that with a video camera and infrared illumination?

I think my soft cervical collar is preventing my chin from tucking, but this morning the strap was partly loose and the collar was dislodged a little bit.

Thanks very much for these stair-step suggestions.  I'll give them a try.

Re: central apneas, they have pretty consistently been about 2/3 of the total events over the 163 nights I've used the Resmed Airsense 11, almost no matter the setting.  Am I a candidate for an ASV machine?

[gainerfull]

I haven't tried recording myself, but I'll consider it.  Would I do that with a video camera and infrared illumination?

I think my soft cervical collar is preventing my chin from tucking, but this morning the strap was partly loose and the collar was dislodged a little bit.

Thanks very much for these stair-step suggestions.  I'll give them a try.

Re: central apneas, they have pretty consistently been about 2/3 of the total events over the 163 nights I've used the Resmed Airsense 11, almost no matter the setting.  Am I a candidate for an ASV machine?

Yeah, you'd need to find a web cam capable of night vision and most outdoor cameras provide night vision like this:

https://www.homedepot.com/p/WYZE-Cam-v3-...nd-reviews

I don't remember but do you have access to a Resmed Aircurve 10 VAUTO or bilevel machine? With the aircurve you can set your trigger sensitivity to high / very high and that can help with central events. If they persist and are numerous then I think you'd be a candidate for ASV.

[mperry99]

Thanks.  i have a Resmed 11 Airsense.  So, I will find another doctor to discuss how I might address the Central Apnea, maybe with a Resmed Aircurve.

The "specialist" at the sleep clinic was particulary vague and unhelpful when i asked her about this a month ago.

She and others there don't understand that OSCAR data is from the same source as what comes into their clinical software.  So, they won't use OSCAR data as a basis for discussion, nor will they show me the numbers from their view of the data.  Frustrating!